Paths to Precision Medicine: A Perspective

Cancer is a complex, heterogeneous disease, driven by multiple molecular pathways. There are hundreds of known oncogenes, which arise in myriad combinations, making every case of cancer a rare disease. As a result, traditional, high cost, tertiary centre clinical trials are reaching the limits of their power, even with their recent adaptive and stratified innovations. Here we
explore how to repurpose the whole cancer care system, using stratified outcome registries, to create a system -wide continuous learning loop.